ACE Kids Act of 2015

Preventing cuts to Medicare Graduate Medical Education payments: "The Medicare IME Pool Act of 2015" (H.R. 3292); preventing cuts to Disproportionate Share Hospital Payments: "The Strengthening DSH and Medicare Through Subsidy Recapture and Payment Reform Act of 2015" (H.R. 3288); Preventing reductions to Hospital Inpatient and Outpatient PPS Payments: "The Medicare Crosswalk Hospital Code Development Act of 2015" (H.R. 3291), Medicare payments for Off-Campus Hospital outpatient departments; implementation of Section 603 "Bipartisan Budget Act of 2015)" (H.R. 1314), "Helping Hospitals Improve Patient Care Act of 2016" (H.R. 5273) 21st Century Cures Act (H.R. 34); CY 2017 Medicare Hospital Outpatient Prospective payment system proposed rule: Provider reimbursements for end of life care counseling; Additional Medicare support for Medicare Graduate Medical Education; Allowing nurse practitioners, certified nurse-midwives, and clinical nurse specialists to certify home health service for Medicare patients: "Home Health Care Planning Improvement Act" (S 578); Medicare payment for short hospital stays; Preventing reductions to the Medicaid program including the provider tax; Improvements to the Medicaid program for medically complex children: "Advancing Care for Exceptional Children Act of 2015" (H.R. 546/S 298).

Client expense: $70,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Hospital and physician payments under Medicare and Medicaid, general. Medicare/ Medicaid Reform- (Bundling of Medicare acute and post-acute hospital payments, payments for readmissions, value-based purchasing, physician self-referral)- Implementation of the Patient Protection and Affordable Care Act (Pub. Law 111-148) and the Health Care and Education Reconciliation Act of 2012 (Pub. Law 111-143). Medicare site neutral payments State of Texas Medicaid Transformation Waiver, Section 1115 of Social Security Act Medicare sequestration Federal exchange subsidies under The Affordable Care Act Two Midnight Rule Recovery Audit Contractor program reform. HR. 546- "The ACE Kids Act" of 2015 Florida's Medicaid Low Income Pool Medicare and Medicaid Disproportionate Share Hospital funding 2017 Medicare Outpatient Payment Rule American Health Care Act of 2017 (H.R. 1628) VA Choice Act Accountable Care Organization (ACO) programs

Client expense: $400,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Consumer Financial Protection Bureau (CFPB), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

Hospital and physician payments under Medicare and Medicaid, general. Medicare/ Medicaid Reform- (Bundling of Medicare acute and post-acute hospital payments, payments for readmissions, value-based purchasing, physician self-referral)- Implementation of the Patient Protection and Affordable Care Act (Pub. Law 111-148) and the Health Care and Education Reconciliation Act of 2012 (Pub. Law 111-143). Medicare site neutral payments State of Texas Medicaid Transformation Waiver, Section 1115 of Social Security Act Medicare sequestration Federal exchange subsidies under The Affordable Care Act Two Midnight Rule Recovery Audit Contractor program reform. HR. 546- "The ACE Kids Act" of 2015 Florida's Medicaid Low Income Pool Medicare and Medicaid Disproportionate Share Hospital funding 2017 Medicare Outpatient Payment Rule American Health Care Act of 2017 (H.R. 1628)

Client expense: $400,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Consumer Financial Protection Bureau (CFPB), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

Preventing cuts to Medicare Graduate Medical Education payments: "The Medicare IME Pool Act of 2015" (H.R. 3292); preventing cuts to Disproportionate Share Hospital Payments: "The Strengthening DSH and Medicare Through Subsidy Recapture and Payment Reform Act of 2015" (H.R. 3288); Preventing reductions to Hospital Inpatient and Outpatient PPS Payments: "The Medicare Crosswalk Hospital Code Development Act of 2015" (H.R. 3291), Medicare payments for Off-Campus Hospital outpatient departments; implementation of Section 603 "Bipartisan Budget Act of 2015)" (H.R. 1314), "Helping Hospitals Improve Patient Care Act of 2016" (H.R. 5273) 21st Century Cures Act (H.R. 34); CY 2017 Medicare Hospital Outpatient Prospective payment system proposed rule: Provider reimbursements for end of life care counseling; Additional Medicare support for Medicare Graduate Medical Education; Allowing nurse practitioners, certified nurse-midwives, and clinical nurse specialists to certify home health service for Medicare patients: "Home Health Care Planning Improvement Act" (S 578); Medicare payment for short hospital stays; Preventing reductions to the Medicaid program including the provider tax; Improvements to the Medicaid program for medically complex children: "Advancing Care for Exceptional Children Act of 2015" (H.R. 546/S 298).

Client expense: $50,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Quality measures related to maternal fetal medicine; ACE Kids Act of 2015 (previously H.R. 546/S. 298); CHIP Reauthorization; Medicaid policies

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Preventing cuts to Medicare Graduate Medical Education payments: "The Medicare IME Pool Act of 2015" (H.R. 3292); preventing cuts to Disproportionate Share Hospital Payments: "The Strengthening DSH and Medicare Through Subsidy Recapture and Payment Reform Act of 2015" (H.R. 3288); Preventing reductions to Hospital Inpatient and Outpatient PPS Payments: "The Medicare Crosswalk Hospital Code Development Act of 2015" (H.R. 3291), Medicare payments for Off-Campus Hospital outpatient departments; implementation of Section 603 "Bipartisan Budget Act of 2015)" (H.R. 1314), "Helping Hospitals Improve Patient Care Act of 2016" (H.R. 5273) 21st Century Cures Act (H.R. 34); CY 2017 Medicare Hospital Outpatient Prospective payment system proposed rule: Provider reimbursements for end of life care counseling; Additional Medicare support for Medicare Graduate Medical Education; Allowing nurse practitioners, certified nurse-midwives, and clinical nurse specialists to certify home health service for Medicare patients: "Home Health Care Planning Improvement Act" (S 578); Medicare payment for short hospital stays; Preventing reductions to the Medicaid program including the provider tax; Improvements to the Medicaid program for medically complex children: "Advancing Care for Exceptional Children Act of 2015" (H.R. 546/S 298).

Client expense: $50,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health care appropriations and authorization issues; Implementation America's Affordable Health Care Act of 2009; Department of Veterans Affairs funding for behavioral health care; ACE Kids Act of 2015 (S.298/H.R.546).

Client expense: Not reported · Firm income: $40,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Health care appropriations and authorization issues; Implementation of America's Affordable Health Care Act of 2009; Funding for veteran and behavioral health care; ACE Kids Act of 2015 (S.298/H.R.546).

Client expense: Not reported · Firm income: $40,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Hospital and physician payments under Medicare and Medicaid, general. Medicare/ Medicaid Reform- (Bundling of Medicare acute and post-acute hospital payments, payments for readmissions, value-based purchasing, physician self-referral)- Implementation of the Patient Protection and Affordable Care Act (Pub. Law 111-148) and the Health Care and Education Reconciliation Act of 2012 (Pub. Law 111-143). Medicare site neutral payments State of Texas Medicaid Transformation Waiver, Section 1115 of Social Security Act Medicare sequestration Federal exchange subsidies under The Affordable Care Act Two Midnight Rule Recovery Audit Contractor program reform. HR. 546- "The ACE Kids Act" of 2015 Florida's Medicaid Low Income Pool Medicare and Medicaid Disproportionate Share Hospital funding 2017 Medicare Outpatient Payment Rule American Health Care Act of 2017 (H.R. 1628)

Client expense: $380,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Consumer Financial Protection Bureau (CFPB), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

Hospital and physician payments under Medicare and Medicaid, general. Medicare/ Medicaid Reform- (Bundling of Medicare acute and post-acute hospital payments, payments for readmissions, value-based purchasing, physician self-referral)- Implementation of the Patient Protection and Affordable Care Act (Pub. Law 111-148) and the Health Care and Education Reconciliation Act of 2012 (Pub. Law 111-143). Medicare site neutral payments State of Texas Medicaid Transformation Waiver, Section 1115 of Social Security Act Medicare sequestration Federal exchange subsidies under The Affordable Care Act Two Midnight Rule Recovery Audit Contractor program reform. HR. 546- "The ACE Kids Act" of 2015 Florida's Medicaid Low Income Pool Medicare and Medicaid Disproportionate Share Hospital funding 2017 Medicare Outpatient Payment Rule American Health Care Act of 2017 (H.R. 1628)

Client expense: $380,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Consumer Financial Protection Bureau (CFPB), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

Prevention & Public Health Fund (PPHF) - support for funding including NECCC; and support for S.298/HR 546 ACE Kids Act; S.689 Sports Medicine licensing; CHIPRA (no bill #); Race for Kids Act S.3239, H.R. 5858; P.L. 114-255 21st Century Cures Act (biomedical research/precision medicine and mental health provisions for children); Maternal, Infant, and Early Childhood Home Visiting Program

Client expense: $86,077 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, SENATE

Prevention & Public Health Fund (PPHF) - support for funding including NECCC; support for maintaining child nutrition reauthorization, specifically CACFP, school lunch and breakfast programs; and support for S.298/HR 546 ACE Kids Act; S.689 Sports Medicine licensing; CHIPRA (no bill #); Race for Kids Act S.3239, H.R. 5858; P.L. 114-255 21st Century Cures Act (biomedical research/precision medicine and mental health provisions for children); Maternal, Infant, and Early Childhood Home Visiting Program

Client expense: $86,077 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, SENATE

Access to Better Care Act(H.R.5652) ACE Kids Act (S.298/H.R.546) Advancing NIH Strategic Planning and Representation in Medical Research Act(S.2745) Advancing Research for Neurological Diseases Act(S.849/H.R.292) American Heart Month Resolution(S.Res.365) 21st Century Cures Act(H.R.6) Common Sense Savings Act (H.R.4725) Community Parks Revitalization Act (H.R.201) Community Prevention Grants Congenital Heart Futures Reauthorization Act of 2015(S.2248/H.R.3952) Credit for Caring Act(H.R.4708/S.2759) End of Life Care Legislation End Surprise Billing Act(H.R.3770) Enhancing the Stature and Visibility of Medical Rehabilitation Research at NIH Act(H.R.1631/S.800) Indian Health Service Health Professions Tax Fairness Act (H.R.1842/S.536) Menu Labeling (ACA Section 4205) No Child Left Inside Act(H.R.882/S.492) Physical Activity Recommendations for Americans (H.R.1499/S.1793) Prevention and Public Health Fund (ACA Section 4002) Personal Health Investment Today Act (PHIT) (H.R.1218/ S.2218) Public Lands Service Corps Act (H.R.2167/S.1160) RAISE Family Caregivers Act (S.1719/H.R.3099) Reducing Obesity in Youth Act(S.3194) Health Equity and Accountability Act (H.R.5475)

Client expense: $166,728 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Education, Dept of, Environmental Protection Agency (EPA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

Implementation of Health care reform generally pertaining to pediatric healthcare and autism services Medicaid program reforms, including hospital outpatient department regulations H.R. 546 and S.298 (ACE Kids Act of 2015), all provisions Section 340B Drug Pricing program H.R. 6 and H.R. 34(21st century cures Act), entire bill and senate companion FDA reform legislation generally Stark Law Reform generally H.R. 5273 (Helping Hospitals Improve Patient Care Act of 2016), Section 201, regarding hospital outpatient departments Hospital Outpatient Prospective payment system regulations regarding hospital outpatient department regulations Federal Policy regarding United Network for Organ Sharing (UNOS) and allocation of donated organs Re-authorization of Children's Hospital Graduate Medical Education program Sickle Cell Disease research funding generally re-authorization of Children's Health Insurance Program Pediatric cancer research generally

Client expense: $121,385 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3441, the Accurate Education for Prenatal Screenings Act Down syndrome research funding Advancing Care for Exceptional (ACE) Kids Act (S. 298/H.R. 546)

Client expense: Not reported · Firm income: $7,500

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 546/S. 298, the ACE Kids Act

Client expense: $80,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Reimbursement environment for hospitals. Barriers to care coordination. Site-Neutral Payments. GME Funding. ACE Kids Act (H.R.546, S.298) Senate Chronic Care Working Group. MACRA implementation. Helping Hospitals Improve Patient Care Act (H.R. 5273). Treatment of off-campus HOPDs (H.R. 34).

Client expense: Not reported · Firm income: $50,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

S. 298, HR 546 Advancing Care for Exceptional Kids Act of 2015; Mental Health delivery system reform; 21st Century Cures; Medicare Advantage; physician payment reform; Chronic Care models of care; Advance Notice of Methodological Changes for Calendar Year (CY) 2017 for Medicare Advantage (MA) Capitation Rates, Part C and Part D Payment Policies and 2017 Call Letter

Client expense: Not reported · Firm income: $140,000

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 546/S. 298, the ACE Kids Act

Client expense: $50,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Specialty drugs' effects on health care premiums.; Chronic Care models of care H.R. 2646, the Helping Families in Mental Health Crisis Act Energy and Commerce; Advance Notice of Methodological Changes for Calendar Year (CY) 2017 for Medicare Advantage (MA) Capitation Rates, Part C and Part D Payment Policies and 2017 Call Letter. Advancing Care for Exceptional Kids Act of 2015 (H.R. 546. S. 298).

Client expense: Not reported · Firm income: $30,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

S. 2104, Preserving Medicare Advantage for all Medicare Beneficiaries Act of 2015; HR 4275, Medicare Advantage Quality Payment Relief Act of 2015; Advance Notice of Methodological Changes for Calendar Year (CY) 2017 for Medicare Advantage (MA) Capitation Rates, Part C and Part D Payment Policies and 2017 Call Letter. Advancing Care for Exceptional Kids Act of 2015 (H.R. 546. S. 298); 21st Century Cures Act; FY 2017 Continuing Resolution

Client expense: Not reported · Firm income: $30,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Medicaid reform ACE Kids program -- communicated concerns with S298 and HR546 Mental Health services paid for through Medicaid managed care arrangements. Specifically commented on HR 2646. Other related issues include mental health parity requirements specific to Medicaid managed care plans (as required by SSA 1932(b)8.

Client expense: $125,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H. Con. Res. 125 - House FY17 budget resolution; H.R. 2 - Medicare Access and CHIP Reauthorization Act of 2015; S. 183 - The Jobs and Premium Protection Act; H.R. 928 - To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Ac; H.R. 2635/S. 1961 - A Bill to make improvements to the treatment of the United States territories under the Medicare and Medicaid programs; S. 298/H.R. 546 - ACE Kids Act of 2015: (Issues related to health insurance provider fees, extending funding for the Children's Health Insurance Program, Medicare and Medicaid issues). H.R. 6 - 21st Century Cures Act (entire bill).

Client expense: $270,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 34, 21st Century Cures Act (Upton) - Medicare Advantage and Medicaid issues H.R. 546, ACE Kids Act (Barton) - Medicaid Childrens Care Coordination Program H.R. 588, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA enrollment opportunities H.R. 818, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - reducing fraud H.R. 1021, Protecting the Integrity of Medicare Act (Brady) - reducing fraud H.R. 2488, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA open enrollment period H.R. 2505, Increasing Access to Data in Medicare Advantage Act (Kelly) - annual reporting of MA enrollment data H.R. 2506, Preventing Unnecessary Plan Terminations Act (Buchanan) - preventing certain MA plan terminations H.R. 2507, Increasing Regulatory Fairness Act (Brady) - schedule for MA rates H.R. 2570, Strengthening Medicare Advantage through Innovation and Transparency for Seniors Act (Black) - Value-Based Insurance Design demonstration H.R. 2579, Securing Care for Seniors Act (Black) - MA risk adjustment model H.R. 2581, Preservation of Access for Seniors in Medicare Advantage Act (Brady) - Value-Based Insurance Design demonstration and MA open enrollment period H.R. 2582, Seniors Health Care Plan Protection Act (Buchanan) - preventing certain MA plan terminations, MA risk adjustment model H.R. 3718, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - reducing fraud H.R. 3716, Ensuring Access to Quality Medicaid Providers Act (Bucshon) - oversight of terminated Medicaid providers H.R. 4275, Medicare Advantage Quality Payment Relief Act (Kelly) - calculation of MA benchmark cap H.R. 4442, CONNECT for Health Act (Black-Welch) - telehealth, remote patient monitoring services H.R. 4589, Excellence in Medicare Act (MacArthur) - MA payment cap H.R. 5273, Helping Hospitals Improve Patient Care Act (Tiberi) - MA issues, site-neutral payments H.R. 5506, Dialysis PATIENT Demonstration Act (Young) - demonstration program for Medicare beneficiaries with ESRD H.R. 5659, ESRD Choice Act (Smith) - option for ESRD patients to enroll in MA plans H.R. 5942, Dialysis PATIENTS Demonstration Act (Young) - demonstration program for Medicare beneficiaries with ESRD H.R. 6265, Medigap Reforms (McDermott) S. 298, ACE Kids Act (Grassley) - Medicaid Childrens Care Coordination Program S. 524, Comprehensive Addiction and Recovery Act (Whitehouse) - Medicare Part D lock-in programs S. 861, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Enzi) - reducing fraud S. 1347, Electronic Health Fairness Act - preventing certain MA plan terminations, annual reporting of MA enrollment data S. 1396, Value-Based Insurance Design Seniors Copayment Reduction Act (Thune-Stabenow) - VBID demonstration S. 1549, Care Planning Act (Warner) - advanced illness care coordination for Medicare beneficiaries S. 1913, Stopping Medication Abuse and Protecting Seniors Act (Toomey) - Medicare Part D lock-in programs S. 2104, Preserving Medicare Advantage for all Medicare Beneficiaries Act (Portman-Casey) - preventing certain MA plan terminations, MA demonstration program S. 2349, Medicare Advantage Coverage Transparency Act (Heller) - MA enrollment data S. 2484, CONNECT for Health Act (Schatz-Wicker) - telehealth, remote patient monitoring services S. 2864, RxCAP Act (Wyden) - Medicare Part D cost-sharing S. 3090, Dialysis PATIENT Demonstration Act (Heller) - demonstration program for Medicare beneficiaries with ESRD S. 3504, Chronic Care Act (Hatch-Wyden-Isakson-Warner) - chronic care reforms, Medicare Advantage provisions Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, encounter data and other data-related issues, and audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, Part D direct and indirect remuneration (DIR), and audits); in-home health risk assessments; Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, enrollment rules, requirements for notice and denial forms, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible SNPs; Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); CMS's proposed Part B drug demonstration program; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's value-based insurance design (VBID) demonstration; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) changes to the Part D coverage gap; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; new payment system for physicians under MACRA, including implications for MA and Part D plans; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); Medicaid managed care regulations and policies, including CMS' proposed substantial revisions to the managed care regulations, new mental health parity rules, the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans; issues related to Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; issues related to Medigap coverage; issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); cybersecurity; provider directories; value-based insurance design models; Part D prescriber enrollment requirements; Part D recovery audit contractor programs; issues relating to enrollment of beneficiaries with ESRD into MA plans; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation. *Add MACPAC to Agency List.

Client expense: $1,330,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Treasury, Dept of, White House Office

Quality measures related to maternal fetal medicine; H.R. 546/S. 298 ACE Kids Act of 2015

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicaid managed care plans; H.R. 546/S. 298, Advancing Care for Exceptional Kids Act of 2015; mental health reform, specifically H.R. 2646, Helping Families in Mental Health Crisis Act of 2015, S. 1945, Mental Health Reform Act of 2015, and S. 2680, Mental Health Reform Act of 2016;and Medicaid reform efforts.

Client expense: Not reported · Firm income: $37,500

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitor legislation impacting persons with disabilities; Outreach to Members of Congress on matters of disability legislation in general, and specifically seek support for the following: H.R. 4794, ABLE Financial Planning Act H.R. 4795 ABLE to Work Act of 2016 H.R. 4813 ABLE Adjustment Act H.R. 546 ACE Kids Act H.R. 3441 Accurate Education for Prenatal Screenings Act S. 2704 ABLE Age Adjustment Act 2. 2702 ABLE to Work Act S. 2703 ABLE Financial Planning Act S. 298 ACE Kids Act and Monitor and advocate for Appropriations for Financial Literacy Tools for individuals with disabilities

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitor legislation impacting persons with disabilities; Outreach to Members of Congress on matters of disability legislation in general, and specifically seek support for the following: H.R. 4794, ABLE Financial Planning Act H.R. 4795 ABLE to Work Act of 2016 H.R. 4813 ABLE Adjustment Act H.R. 546 ACE Kids Act H.R. 3441 Accurate Education for Prenatal Screenings Act S. 2704 ABLE Age Adjustment Act 2. 2702 ABLE to Work Act S. 2703 ABLE Financial Planning Act S. 298 ACE Kids Act and Monitor and advocate for Appropriations for Financial Literacy Tools for individuals with disabilities

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitor legislation impacting persons with disabilities; Outreach to Members of Congress on matters of disability legislation in general, and specifically seek support for the following: H.R. 4794, ABLE Financial Planning Act H.R. 4795 ABLE to Work Act of 2016 H.R. 4813 ABLE Adjustment Act H.R. 546 ACE Kids Act H.R. 3441 Accurate Education for Prenatal Screenings Act S. 2704 ABLE Age Adjustment Act 2. 2702 ABLE to Work Act S. 2703 ABLE Financial Planning Act S. 298 ACE Kids Act and Monitor and advocate for Appropriations for Financial Literacy Tools for individuals with disabilities

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Advantage program; issues related to reimbursements H.R. 546, S. 298 ACE Kids Act

Client expense: $61,086 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Advantage program; issues related to reimbursements H.R. 546, S. 298 ACE Kids Act

Client expense: Not reported · Firm income: $37,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Advantage; issues related to reimbursement H.R. 546, S. 298 ACE Kids Act

Client expense: Not reported · Firm income: $6,150

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Access to Better Care Act(H.R.5652) ACE Kids Act (S.298/H.R.546) Advancing NIH Strategic Planning and Representation in Medical Research Act(S.2745) Advancing Research for Neurological Diseases Act(S.849/H.R.292) American Heart Month Resolution(S.Res.365) 21st Century Cures Act(H.R.6) Common Sense Savings Act (H.R.4725) Community Parks Revitalization Act (H.R.201) Community Prevention Grants Congenital Heart Futures Reauthorization Act of 2015(S.2248/H.R.3952) Credit for Caring Act(H.R.4708/S.2759) End of Life Care Legislation End Surprise Billing Act(H.R.3770) Enhancing the Stature and Visibility of Medical Rehabilitation Research at NIH Act(H.R.1631/S.800) Indian Health Service Health Professions Tax Fairness Act (H.R.1842/S.536) Menu Labeling (ACA Section 4205) No Child Left Inside Act(H.R.882/S.492) Physical Activity Recommendations for Americans (H.R.1499/S.1793) Prevention and Public Health Fund (ACA Section 4002) Personal Health Investment Today Act (PHIT) (H.R.1218/ S.2218) Public Lands Service Corps Act (H.R.2167/S.1160) RAISE Family Caregivers Act (S.1719/H.R.3099) Reducing Obesity in Youth Act(S.3194) Health Equity and Accountability Act (H.R.5475)

Client expense: $175,017 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Education, Dept of, Environmental Protection Agency (EPA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

Actuarial soundness Appropriate payment, including risk adjustment, for D-SNPs and MMPs Appropriate quality measurement for D-SNPs and MMPs Education, implementation, evaluation, and improvement of coordinated care programs for dual eligibles H.R. 700, Stabilize Medicaid and CHIP Coverage Act High cost specialty medications Legislative solution to address churning in Medicaid/CHIP eligibility and improve quality measurement in both programs Medicaid and Medicare reform discussions with MACPAC and MedPAC Medicaid eligibility and enrollment issues Medicaid health plans serving as qualified health plans in the Exchange Medicaid managed care regulations Medicaid quality measurement and improvement Regulatory and systematic impact of Medicaid continuous coverage Risk adjustment S. 428, Stabilize Medicaid and CHIP Coverage Act S. 737, Ensuring Access to Primary Care for Women & Children Act 50th Anniversary of Medicaid HR 2505 HR 2506 HR 2507 HR 2579 ACE Kids Act, HR 546/S 298 Mental Health and Medicaid HR 2646 Medicaid DOC Act; Provider directories S.2104 Impact of enhanced state flexibility in managing Medicaid programs Medicaid eligibility and enrollment issues Medicaid Provider Payments Fraud Waste and Abuse in Medicare and Medicaid H.R.3716/S.2669 regarding prohibiting federal payment under Medicaid for nonemergency services furnished by providers whose participation in Medicaid, Medicare, or CHIP has been terminated H.R.5542 - Medicaid and CHIP Quality Improvement Act of 2016

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Pursuit of federal funding in the Labor-HHS legislation for Children's Hospital GME payments; Support for development of legislation for medically complex children under Medicaid; H.R. 546 & S.298, Advancing Care for Exceptional Kids Act of 2015.

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Public Law 111-48, "Patient Protection and Affordable Car Act" and Public Law 111-52, "Health Care and Education Reconciliation Act 2010"--monitored implementation of key Medicaid and health insurance market provisions. HR 928, "To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act". S 831, "Jobs and Premium Protection Act" S 3130, "Independence at Home Act of 2016" HR 546 and S 298 "Advancing Care for Exceptional Kids Act of 2015 (ACE Kids Act of 2015)

Client expense: $290,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 546/S. 298, ACE Kids Act of 2015; H.R. 5325, Continuing Appropriations and Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2017, and Zika Response and Preparedness Act, issues relating to health care; Potential legislation to modify the Patient Protection and Affordable Care Act (PL 111-148); Implementation of the Patient Protection and Affordable Care Act (PL 111-148), issues and potential legislation relating to insurer fees, issues relating to health insurance market provisions; Implementation of the Consolidated Appropriations Act, 2016 (P.L. 114-113), including provisions relating to health insurance tax; Issues related to Health Insurance Tax (HIT); Issues related to Medicaid; Issues related to Montana Veterans Affairs services.

Client expense: Not reported · Firm income: $60,000

HR 546 and S 298 Advancing Care for Exceptional Children, and how it might relate to children in the military health system

Client expense: Not reported · Firm income: $10,000

Government targets: Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Joint Chiefs of Staff, SENATE, White House Office

S 298 and HR 546 Advancing Care for Exceptional Children Act of 2015 - facilitating complex care models in Medicaid for children with complex conditions, S 2680 regarding children's behavioral and mental health needs

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 298 and HR 546 Advancing Care for Exceptional Children Act of 2015 - facilitating complex care models in Medicaid for children with complex conditions

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and policies related to: Physician/nurse practitioner reimbursement Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Adoption of recommendations of the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health Medicare Shared Savings Program beneficiary assignment requirements Medicare-Medicaid hospital conditions of participation Evaluation of the Medicare Graduate Nurse Education demonstration Medicare-Medicaid Program Integrity policies Medicaid maintenance of effort requirements Medicaid eligibility expansion and state options Medicaid waiver application procedures Medicaid per capita cap policy options Medicare-Medicaid dual eligible coverage and demonstration Draft Hospital Improvement for Payment (HIP) Act HHS study on the comparability of CHIP coverage and benefits with those of marketplace health plans Medicare provisions of H.R. 1892, the Trade Adjustment Assistance Act H.R. 2 - Medicare Access and CHIP Reauthorization Act H.R. 160/S. 149 - Protect Medical Innovation Act H.R. 546/S. 298 - Advancing Care for Exceptional Kids (ACE Kids) Act H.R. 700 - Stabilize Medicaid and CHIP Coverage Act H.R. 818/S. 861 - Preventing and Reducing Improper Medicare and Medicaid Expenditures (PRIME) Act H.R. 876 - Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act H.R. 919 - CHIP Extension and Improvement Act H.R. 1021 - Protecting Integrity of Medicare Act (PIMA) H.R. 1190/S. 141 - Protecting Seniors Access to Medicare Act H.R. 1362 - Medicaid Requiring Expenditures for Public Objectives to be Reflective of Total Spending (Medicaid REPORTS) Act H.R. 1458 - Bundling and Coordinating Post-Acute Care (BACPAC) Act H.R. 1470 - SGR Repeal and Medicare Provider Payment Modernization Act H.R. 2339 - To amend title XIX of the Social Security Act to clarify the treatment of lottery winnings and other lump sum income for purposes of income eligibility under the Medicaid program H.R. 3014 - Medical Controlled Substances Transportation Act H.R. 3134 - Defund Planned Parenthood Act of 2015 H.R. 3292 - Medicare IME Pool Act H.R. 3298 - Medicare Post-Acute Care Value-Based Purchasing Act H.R. 3716 - Ensuring Terminated Providers Are Removed From Medicaid and CHIP Act H.R. 3821/S. 2618 - Medicaid Directory of Caregivers (Medicaid DOC) Act H.R. 4588 - Incentivizing Medicaid Expansion Act of 2016 H.R. 4725 - Common Sense Savings Act of 2016 H.R. 5164 - Rural Hospital Regulatory Relief Act H.R. 5122 - To prohibit further action on the proposed rule regarding testing of Medicare part B prescription drug models H.R. 5210/S. 2736 - Patient Access to Durable Medical Equipment Act H.R. 5273 - Helping Hospitals Improve Patient Care Act of 2016 H.R. 5613/S. 3129 - Continuing Access to Hospitals Act of 2016 S. 257/H.R. 1611 - Protecting Access to Rural Therapy Services Act S. 578/H.R. 1342 - Home Health Care Planning Improvement Act S. 737/H.R. 2253 - Ensuring Access to Primary Care for Women & Children Act S. 1349 - Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act S. 1456 - Rural ACO Improvement Act S. 1461 - Extending a moratorium on enforcement of direct physician supervision of outpatient therapeutic services in critical access and small rural hospitals through 2015 S. 2425 - Patient Access and Medicare Protection Act S. 2787 - States Achieve Medicaid Expansion (SAME) Act S. 3130 - Independence at Home Act of 2016

Client expense: Not reported · Firm income: $23,450

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

Advancing Care for Exceptional (ACE) Kids Act (H.R. 546); provisions related to the care of medically complex pediatric patients. Stop OD Act (H.R. 5432), and other Opiate issues; general issues related to the role of clinical providers in the care of addicted patients. Never Again Act (H.R. 6108); provisions related to non-department facilities. Issues related to supporting organ donation. Early Hearing Detection and Intervention Act (S.2424); generally

Client expense: $170,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE

Pediatric and child health issues in health care reform implementation, Medicaid and CHIP coverage, pediatric quality measurement, graduate medical education. H.R.546/S. 298 - ACE Kids Act of 2015. Suggested improvements to out of state provider screening and enrollment processes.

Client expense: $170,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE

Medicare improvements for retired servicemembers and military families. H.R. 546 and S. 298, ACE Kids Act Amends titles XIX (Medicaid) and XXI (Children's Health Insurance) (CHIP) of the Social Security Act to allow a state, at its option, to elect to provide medical assistance for items and services furnished to eligible children with medically complex conditions enrolled in a Medicaid Children's Care Coordination (MCCC) program.

Client expense: $981,891 · Firm income: Not reported

Government targets: Air Force, Dept of, Army, Dept of (Corps of Engineers), Army, Dept of (Other), Commerce, Dept of (DOC), Congressional Budget Office (CBO), Consumer Financial Protection Bureau (CFPB), Defense Finance & Accounting Service (DFAS), Defense, Dept of (DOD), Government Accountability Office (GAO), Government Printing Office (GPO), HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), Natl Guard, Natl Oceanic & Atmospheric Administration (NOAA), Navy, Dept of, Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Secretary of Defense, President of the U.S., SENATE, U.S. Coast Guard (USCG), U.S. Marines, Veterans Affairs, Dept of (VA), Veterans Employment & Training Service

- Medical funding for chronically ill children, specifically HR 546/S.298 - Low Income Pool funding - CMS Cardiac bundled payment initiative - HRSA proposed guidance on 340B

Client expense: $211,558 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE